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Malaria is a life-threatening disease caused by a parasite that is transmitted through the bite of infected female Anopheles mosquitoes. The parasite that causes malaria is a microscopic, single-celled organism called Plasmodium. Malaria is predominantly found in the tropical and sub-tropical areas of Africa, South America and Asia.
If not detected and treated promptly, malaria can be fatal. However, with the right treatment, started early enough, it can be cured.
It is estimated that there were million cases of malaria in and , deaths. There are six different species of malaria parasite that cause malaria in humans: Plasmodium falciparum , Plasmodium vivax , Plasmodium ovale curtisi , Plasmodium ovale wallikeri , Plasmodium malariae and the very rare Plasmodium knowlesi. If community support for health sector initiatives is to be guaranteed, the public needs to know much more about malaria, its risks for epidemics and severe disease, and difficulties in control.
Given the limited available financial and human resources and a dwindling pool of effective. The committee believes that the first and most basic priority in malaria control is to prevent infected individuals from becoming severely ill and dying. Reducing the incidence of severe morbidity and malaria-related mortality requires a two-pronged approach.
First, diagnostic, treatment, and referral capabilities, including the provision of microscopes, training of technicians and other health providers, and drug supply, must be enhanced. Second, the committee believes that many malaria-related deaths could be averted if individuals and caretakers of young children knew when and how to seek appropriate treatment and if drug vendors, pharmacists, physicians, nurses, and other health care providers were provided with up-to-date and locally appropriate treatment and referral guidelines.
The development and implementation of an efficient information system that provides rapid feedback to the originating clinic and area is key to monitoring the situation and preventing epidemics. The committee believes that the second priority should be to promote personal protection measures e. At the present time, insecticide-treated bednets appear to be the most promising personal protection method. In many environments, in addition to the treatment of individuals and use of personal protection measures, community-wide vector control is feasible.
In such situations, the committee believes that the third priority should be low-cost vector control measures designed to reduce the prevalence of infective mosquitoes in the environment, thus reducing the transmission of malaria to populations. These measures include source reduction e. In certain environments, the use of insecticide-impregnated bednets by all or most members of a community may also reduce malaria transmission, but this approach to community-based malaria control remains experimental. The committee believes that the fourth priority for malaria control should be higher cost vector control measures such as large-scale source reduction or widespread spraying of residual insecticides.
In certain epidemiologic situations, the use of insecticides for adult mosquito control is appropriate and represents the method of choice for decreasing malaria transmission and preventing epidemics see Chapter 7 and Chapter The committee recommends that support of malaria control programs include resources to improve local capacities to conduct prompt diagnosis, including both training and equipment, and to ensure the availability of antimalarial drugs. The committee recommends that resources be allocated to develop and disseminate malaria treatment guidelines for physicians, drug vendors, pharmacists, village health workers, and other health care personnel in endemic and non-endemic countries.
The guidelines should be based, where appropriate, on the results of local operational research and should include information on the management of severe and complicated disease. The guidelines should be consistent and compatible among international agencies involved in the control of malaria.
The committee recommends that support for malaria control initiatives include funds to develop and implement locally relevant communication programs that provide information about how to prevent and treat malaria appropriately including when and how to seek treatment and that foster a dialogue about prevention and control. One of the major criticisms of malaria control programs during the past 10 to 15 years has been that funds have been spent inappropriately without an integrated plan and without formal evaluation of the efficacy of control measures instituted. In many instances, this has led to diminished efforts to control malaria.
The committee strongly encourages renewed commitment by donor agencies to support national control programs in malaria-endemic countries. The committee recommends that U. The committee believes that the development, implementation, and evaluation of such programs must follow a rigorous set of guidelines.
These guidelines should include the following steps:.
What is malaria?
Determine the extent and variety of malaria. The paradigm approach described in Chapter 10 should facilitate this step. Design and prioritize interventions based on the epidemiologic situation and the available resources. Design a training program for decision makers, managers, and technical staff to support and sustain the interventions. Define specific indicators of the success or failure of the interventions at specific time points.
To guide the implementation of the activities outlined above, the committee has provided specific advice on several components, including an approach to evaluating malaria problems and designing control strategies the paradigm approach , program management, monitoring and evaluation, and operational research. Given the complex and variable nature of malaria, the committee believes that the epidemiologic paradigms see Chapter 10 , developed in conjunction with this study, may form the basis of a logical and reasoned approach for defining the malaria problems and improving the design and management of malaria control programs.
The committee recommends that the paradigm approach be field tested to determine its use in helping policymakers and malaria program managers design and implement epidemiologically appropriate and cost-effective control initiatives. The committee recognizes that various factors, including the local ecology, the dynamics of mosquito transmission of malaria parasites, genetically determined resistance to malaria infection, and patterns of drug use, affect patterns of malaria endemicity in human populations and need to be considered when malaria control strategies are developed.
In most endemic countries, efforts to understand malaria transmission through field studies of vector populations are either nonexistent or so limited in scope that they have minimal impact on subsequent malaria control efforts. The committee recognizes that current approaches to malaria control are clearly inadequate. The committee believes, however, that malaria control strategies are sometimes applied inappropriately, with little regard to the underlying differences in the epidemiology of the disease.
The committee recommends that support for malaria control programs include funds to permit a reassessment and optimization of antimalarial tools based on relevant analyses of local epidemiologic, parasitologic, entomologic, socioeconomic, and behavioral determinants of malaria and the costs of malaria control. Poor management has contributed to the failure of many malaria control programs. Among the reasons are a chronic shortage of trained managers who can think innovatively about health care delivery and who can plan, implement, supervise, and evaluate malaria control programs.
Lack of incentives, the absence of career advancement options, and designation of responsibility without authority often hinder the effectiveness of the small cadre of professional managers that does exist. The committee recognizes that management technology is a valuable resource that has yet to be effectively introduced into the planning, implementation, and evaluation of most malaria control programs. The committee recommends that funding agencies utilize management experts to develop a comprehensive series of recommendations and guidelines as to how basic management skills and technology can be introduced into the planning, implementation, and evaluation of malaria control programs.
Where such an individual does not exist, a priority of the control effort should be to identify and support a qualified candidate. The manager should be supported actively by a multidisciplinary core group with expertise in epidemiology, entomology, the social sciences, clinical medicine, environmental issues, and vector control operations. Monitoring and evaluation are essential components of any control program. For malaria control, it is not acceptable to continue pursuing a specific control strategy without clear evidence that it is effective and reaching established objectives.
The committee recommends that support for malaria control programs include funds to evaluate the impact of control efforts on the magnitude of the problem and that each program be modified as necessary on the basis of periodic assessments of its costs and effectiveness. At the outset of any malaria prevention or control initiative and during the course of implementation, gaps in knowledge will be identified and problems will arise.
These matters should be addressed through clearly defined, short-term, focused studies. Perhaps the most difficult aspects of operational research are to identify the relevant problem, formulate the appropriate question, and design a study to answer that question.
WHO | 10 facts on malaria
The committee recommends that a problem-solving operational research component be built into all existing and future U. This effort will include consistent support in the design of focused projects that can provide applicable results, analysis of data, and dissemination of conclusions. The committee concludes that there is a need for additional scientists actively involved in malaria-related research in the United States and abroad.
To meet this need, both short- and long-term training at the doctoral and postdoctoral levels must be provided. This training will be of little value unless there is adequate long-term research funding to support the career development of professionals in the field of malaria. The committee recommends support for research training in malaria. Whereas the curricula for advanced degree training in basic science research and epidemiology are fairly well defined, two areas require attention, especially in the developing world: social sciences and health management and training.
The committee recommends that support be given for the development of advanced-degree curricula in the social sciences, and in health management and training, for use in universities in developing and developed countries. The availability of well-trained managers, decision makers, and technical staff is critical to the implementation of any malaria prevention and control program.
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The development of such key personnel requires a long term combination of formal training, focused short courses, and a gradual progression of expertise. The committee recommends support for training in management, epidemiology, entomology, social sciences, and vector control. Such training for malaria control may be accomplished through U. The committee recommends further that malaria endemic countries be supported in the development of personnel programs that provide long-term career tracks for managers, decision makers, and technical staff, and that offer professional fulfillment, security, and competitive financial compensation.
History of malaria
Malaria is making a dramatic comeback in the world. The disease is the foremost health challenge in Africa south of the Sahara, and people traveling to malarious areas are at increased risk of malaria-related sickness and death. This book examines the prospects for bringing malaria under control, with specific recommendations for U. The volume reports on the current status of malaria research, prevention, and control efforts worldwide.
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Sign up for email notifications and we'll let you know about new publications in your areas of interest when they're released. Malaria: Obstacles and Opportunities Chapter: 1. Conclusions and Recommendations. Get This Book. Visit NAP. Looking for other ways to read this? No thanks. Suggested Citation: "1. Malaria: Obstacles and Opportunities. Page 2 Share Cite. Each year, over seven million U. Page 3 Share Cite. Page 4 Share Cite. Page 5 Share Cite. Page 6 Share Cite. Page 7 Share Cite.
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Page 9 Share Cite. Commitment and Sustainability. Page 10 Share Cite. Inter-Sectoral Cooperation. New Tools for Malaria Control. Page 11 Share Cite. Coordination and Integration. Page 12 Share Cite. Malaria Research Priorities. Page 13 Share Cite. Research in Support of Available Control Measures. Page 14 Share Cite.
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Development of New Tools. Page 15 Share Cite. Malaria Control. Page 16 Share Cite. Page 17 Share Cite. Organization of Malaria Control. Page 18 Share Cite. Develop a specific plan for reporting on the outcomes of interventions. Review of the comprehensive plan by a donor agency review board Modification of the plan based on comments of the review board Implementation of the program Yearly report and analysis of outcome variables To guide the implementation of the activities outlined above, the committee has provided specific advice on several components, including an approach to evaluating malaria problems and designing control strategies the paradigm approach , program management, monitoring and evaluation, and operational research.
Paradigm Approach. Page 19 Share Cite. Page 20 Share Cite. Problem Solving Operational Research and Evaluation. Page 21 Share Cite. Fact 7: Sleeping under insecticide-treated mosquito nets protects against malaria Long-lasting insecticidal nets provide personal protection against mosquito bites. They can be used as protection for people most at risk of malaria, such as young children and pregnant women in high malaria transmission areas.
The nets are effective for years, depending on the model and conditions of use. Indoor spraying with insecticides kills the mosquito vector and is effective for 3—6 months, depending on the insecticide used and the type of surface on which it is sprayed. Longer-lasting forms of insecticides are under development. Fact 9: Pregnant women are particularly at risk of malaria Pregnant women are at high risk of dying from the complications of severe malaria.
Malaria is also a cause of spontaneous abortion, premature delivery, stillbirth and severe maternal anaemia, and is responsible for about one third of preventable low-birth-weight babies. For pregnant women living in moderate-to-high transmission areas, WHO recommends intermittent preventive treatment at each scheduled antenatal visit after the first trimester.
Fact Malaria causes significant economic losses in high-burden countries In high-burden settings, malaria can trap families and communities in a downward spiral of poverty, disproportionately affecting marginalized and poor people who cannot afford treatment or who have limited access to health care. You are here: Features: stories and photos from countries Fact files 10 facts on malaria.